Color stability and surface roughness of different recent ...

JOURNAL AIN SHAMS DENTAL JOURNAL Official Publication of Ain Shams Dental School

September 2020 • Vol. XXIII Print ISSN 1110-7642

Online ISSN 2735-5039

Color stability and surface roughness of different recent provisional restorative materials” An In vitro study

Mohamed M Dabash1, Hoda M Abdel Sadek2, Omaima S El Mahalawi 3, Tarek S Morsi4.

Abstract Objectives: To evaluate the effects of staining solutions on the color stability and roughness of different provisional resin materials. Materials and methods: The 105 specimens were divided into5 groups according to type of provisional restorations twenty one test specimens for each group (N=21).Each material group specimens subdivided into 3 sub-groups according to coloring solutions (n=7) one group immersed in artificial saliva, the second in coffee solution and the third in mouth wash. Baseline color measurements, using spectrophotometer then after 2 and 4 weeks to measure color change (ΔE) by means of the CIE L*a*b* system. Surface roughness also were measured using profilometer for all specimens before and after immersion in staining solutions. Results: In Color change (ΔE) the results showed that provisional material, Immersion media, and Time had a statistically significant effect on mean ΔE. The interaction between the three variables had a statistically significant effect on mean ΔE indicating that the variables are dependent upon each other. Change in surface roughness (ΔRa), in Comparison between provisional materials: After immersion in the three solutions, there was a statistically significant difference between mean ΔRa of provisional materials. In Comparison between immersion media With Protemp4, Tempron, Vita CAD temp as well as breCAM.multiCOM; there was no statistically significant difference between mean ΔRa of immersion media, but with Tuff temp; there was a statistically significant difference between mean ΔRa of immersion media. Conclusions: Type of provisional restorative materials, staining solutions and immersion times are significant factors that can affect color stability of the five provisional restorative materials tested, type of provisional restorative materials was the only significant factor for surface roughness, so choosing type of material must be the interest regarding to smoothness. Keywords: Provisional materials, immersion media, time of immersion, color change, roughness.

1. Master Degree student, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University. 2. Lecturer, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University. 3. Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Cairo University. 4. Professor, Department of Fixed Prosthodontics, Faculty of Dentistry, Ain Shams University.

COLOR STABILITY AND SURFACE ROUGHNESS OF DIFFERENT RECENT PROVISIONAL RESTORATIVE MATERIALS” AN IN VITRO STUDY| Mohamed M Dabash et al Sep2020

30 ASDJ September 2020 vol XXIII Fixed Prosthodontics, Endodontics, Conservative Section

Introduction:

The Provisional resin restorations

provide interim protection, esthetics,

mastication, and maintain the abutment

position while the definitive restoration is

being fabricated. The surface smoothness

and color stability are two of the most

important requirements of the ideal

provisional resin restorations [1]. The

purpose of this study was to investigate

the difference in performance of

provisional crown materials that were

fabricated either by a traditional direct

technique or with the more sophisticated

indirect CAD/CAM approach. There are

many reasons why the surface of a

restoration should be made as smooth as

possible. It serves to ensure long-term

esthetic success including color stability,

and it is also noteworthy that prosthetic

material wear is partly determined by

surface finishing (i.e., polishing and/ or

glazing)[2]. Material and Methods:

A total of one hundred and fife

specimens (105) specimens fabricated

from 5 provisional resin materials;

3conventional provisional restoration

materials and 2 CAD/CAM provisional

restoration materials. The test samples in

this study were fabricated in the form of

disks measuring 10 mm in diameter and 2

mm in thickness; to standardize disks

sizes. For the manually provional

materials they were prepared using teflon

mold [3, 4] . The mold has a disk space

(dimensions 2 x 10 mm) in which the

manually fabricated provisional

restoration materials (Protemp4,

Tempron and Tuff Temp) were poured to

construct specimens with these

dimensions. After pouring the specimen,

to achieve uniform disk specimen

thickness it was covered and pressed by

glass slide from the top, after curing the

screws was unwind and the two parts

were separated then the specimen

removed easily from the mold space. The

2 CAD/CAM provisional restoration

material specimens will be fabricated by

the same mentioned dimensions using

Isomet saw [5].VITA CAD Temp blocks

were milled under water-cooling

obtaining a cylindrical shape (10 mm of

diameter) and then they were sectioned

using a diamond saw (Isomet saw,



Buehler, Lake Bluff, IL, USA)[6]. A

breCAM.multiCOM disk, was milled

same as vita cad temp. The specimens

were finished by using wetting sand paper

then using Enhance finishing and

polishing system used. Finally the

specimens were ultrasonically cleaned [5,

7, 8].

Figure (1): show an examples of

provisional materials before &after immersion

The 105 specimens were divided into

5 groups according to type of provisional

restorations twenty one test specimens for

each group (N=21). Each material group

specimens subdivided into 3 sub-groups

according to coloring solutions (n=7),

immersed in 20 mL from each solutions;

one group immersed in artificial saliva,

the second in coffee solution and the third

in listerine, then each group coded by the

name of provisional restorations, the

coloring solutions, and the number of the

specimen from 1 to 7[9, 10] as in figure (1).

After obtaining baseline color

measurements, by Spectrophotometer to

measure color change (ΔE) by means of

the CIE L*a*b* system figure (2). The

twenty one specimens of each provisional

restorative materials were placed in a

correspondingly labeled container

containing one of the three immersion

solutions, then incubated[11] at 37°C and

stored in the dark place to simulate body

temperature, and after 2 and 4 weeks[12].

A profilometer (TR200, Qualitest, USA)

figure (2), was used for evaluation of

surface roughness (Ra, μm) of the

specimens before and after immersion

procedures. A diamond stylus (tip radius,

5 μm) was moved across the surface

under a constant load of 0.75 μN[13]. The

optical methods tend to fulfill the need for

quantitative characterization of surface



topography without contact [14]. 3D

Surface Roughness measurement using a

Light Sectioning Vision System.

Figure (2) spectrophotometer,

Profilometer and 3D optical microscope. Results:

Color change (ΔE): The interaction

between the three variables had a

statistically significant effect on mean ΔE

indicating that the variables are

dependent upon each other. Regardless

of immersion media and time; there was

a statistically significant difference

between provisional materials revealed

that Tuff temp showed the statistically

significantly highest mean ΔE, then

Tempron. There was no statistically

significant difference between Protemp4

and breCAM.multiCOM; both showed

statistically significantly lower mean ΔE.

Vita CAD temp showed the statistically

significantly lowest mean ΔE.

Regardless of provisional material and

time; there was a statistically significant

difference between mean ΔE at different

immersion media. Pair-wise comparisons

between immersion media revealed that

coffee showed the statistically

significantly highest mean ΔE. There was

no statistically significant difference

between mouth wash and artificial saliva;

both showed the statistically significantly

lowest mean ΔE values.

Regardless of provisional material

and immersion media; there was a

statistically significant increase in mean

ΔE at second measurement.

Change in surface roughness (ΔRa);

Comparison between provisional

materials: After immersion in mouth

wash; there was a statistically significant



difference between mean ΔRa of

provisional materials, revealed that

Tempron showed the statistically

significantly highest mean ΔRa.

Followed by Tuff temp followed by Vita

CAD temp then Protemp4. All the

previous materials showed an increase in

Ra while breCAM.multiCOM showed a

decrease in Ra with statistically

significant difference from all materials.

After immersion in artificial saliva;

there was a statistically significant

difference between mean ΔRa of

provisional materials, revealed that

Tempron showed the statistically

significantly highest mean ΔRa then Tuff

temp followed by Vita CAD temp then

Protemp4. All the previous materials

showed an increase in Ra while

breCAM.multiCOM showed a decrease

in Ra with statistically significant

difference from all materials. After

immersion in coffee; Tempron showed

the statistically significantly highest

mean ΔRa. There was no statistically

significant difference between Protemp4,

Tuff temp and Vita CAD temp; all

showed statistically significantly lower

mean ΔRa values.

Comparison between immersion

media:

With Protemp4, Tempron, Vita

CAD temp as well as

breCAM.multiCOM; there was no

statistically significant difference

between mean ΔRa of immersion media.

While with Tuff temp; there was a


between mean ΔRa of immersion media

(P-value =0.017, Effect size = 0.341).

Pair-wise comparisons between media

revealed that artificial saliva showed the

statistically significantly highest mean

ΔRa. Mouth wash showed statistically

significantly lower mean value. Coffee

showed the statistically significantly

lowest mean ΔRa.

Discussion:

The five provisional resin restorative

materials used divided into 2 groups

according to the method of construction;

manually fabricated group (Protemp4,

Tuff Temp, Tempron) and CAD/CAM

group (VITA CAD Temp ,Brecam



MultiCom). The introduction of

provisional CAD/CAM restorations

promises a certainly easier method of

fabrication for the clinician, but also

offers potentially stronger provisional

restorations. However, there may be an

impetuous to use CAD/CAM provisional

materials, these restorations comprise a

more expensive alternative to

conventional directly made provisional

restorations. Many trials were applied to

improve the physical and mechanical

properties of provisional resin materials.

Among ways for improvement is the

modification of fabrication method as

direct, indirect fabrication and milling

from CAD/CAM resin blocks.

Results of color showed; effects of

provisional materials: Tuff temp

showed the highest color change in the

present study, may be due to most bis-

acryl polymers are more polar than

PMMA. Additionally dual-cured

composite materials color stability

depends on the photoinitiator component,

resin matrix composition, light-curing

device, and irradiation time, so chemical

discoloration has been attributed to an

oxidation of the polymer matrix or

oxidation of unreacted double bonds[16]

and agreed with Sultan R. Binalrimal,

Peter Yaman [17]. On the other hand

results revealed that tempron has color

change more than protem4 which was

unlike tuff temp and the previous studies;

may be due to manipulation technique

(powder‑liquid). It demonstrated air

inclusions surface voids and porosity of

this material which were evident after

polishing which contribute to color

change noted in this study more than

protem4,which agreed with numerous

studies [9, 18, 19] however, these values

disagree and differ from the studies of

Rutkunas and et al[24] Jalali [25]. And

BreCAM.multiCOM are polymerized

under controlled and standardized

industrial conditions with optimized

pressure and temperature parameters.

This leads to a higher color stability of

CAD/CAM- fabricated temporary

restorations from industrially fabricated

resin blocks, compared to conventionally

fabricated ones. Agreed with Köroğlu [13]

And with Rayan[26, 27]. Vita CAD temp


http://www.ijdr.in/searchresult.asp?search=&author=Hamid+Jalali&journal=Y&but_search=Search&entries=10&pg=1&s=0



lowest mean ΔE; due to in addition to

advantages of CAD CAM fabrication

technique, it consists of a fiber-free,

homogeneous, high-molecular and cross-

linked acrylate polymer with micro-

particle filler. And because the more

homogeneous a polymer is, the less water

is absorbed and the less soluble

characteristics it has, which agreed with [28, 29]. Result revealed that coffee showed

the statistically significantly highest

mean ΔE. There was no statistically

significant difference between mouth

wash and artificial saliva; may be due

to the smaller molecular size of coffee

coupled with both water absorption and

adsorption[30] of polar colorants onto the

surface of materials. characteristic of the

tested materials, creating a stronger

staining effect[31]. Listerine has some

physical-mechanical properties of resin

composites, softening the aesthetic

restorative materials and significantly

increasing the biodegradation of the resin

composites over time, which agree with

Canan Akay [35].Also artificial saliva

resulted in visible color changes in the

materials that may due to water

accumulation and photo-oxidation

affected the internal colors of provisional

restorative materials[24, 36-38]. There was a

statistically significant increase in mean

ΔE at second measurement. As the

duration of immersion increased, longer

the material is exposed to various factors,

the greater the chances for color alteration

and increased roughness as with da

Fonsêca Costa[9] Results of Roughness

revealed that; all the previous materials

showed an increase in Ra while

BreCAM.multiCOM showed a decrease

in Ra with statistically significant

difference from all materials. Tempron


highest mean ΔRa in the all immersion

media followed by Tuff temp, this

explained by small, but visible, surface

voids and porosity of the material which

were evident after polishing of the

Tempron specimens. Tuff-Temp is ure-

thane dimethacrylate (UDMA), which is

a bis-acrylic material showed high

surface roughness may be due to its

polarity so has great affinity to water,

similar to the study findings of Ayuso-

Montero,[19] and in contrast, several



studies [18, 39, 40]noted the smoother

surfaces of methacrylate resins compared

with those of bis-acryl composite resins.

Protemp4 showed lower mean ΔRa

than Vita CAD temp; the addition of

nanofillers was claimed to provide a

smooth surface after the polishing

process .Which agree with Hamad et al [77]; the addition of nano-silica (nano-

SiO2) and (nano-Al2O3) particles has a

noticeable effect on the all properties; but

disagree with the study that showed; the

surface of the CAD/CAM provisional

crowns were smoother than the Bis-acryl

provisional crowns. And Anja

Liebermann[29] ,showed that the highest

solubility was observed for the

conventional protem4.

BreCAM.multiCOM showed the

lowest mean ΔRa; despite VITA CAD-

Temp was CAD CAM fabricated , but

the chemical structure of

BreCAM.multiCOM that consist of

polymethyl methacrylate and has been

offset with >20% ceramic filers and

VITA CAD-Temp that consist of a high-

molecular and cross-linked acrylate

polymer with 14 % microparticle filler

(silica). But disagree with Sen et al. [22]who reported presence of filler

particles may prevent the surface of the

material from being smoothed [39],and

said the fillers to cause protrusions to be

formed over the surface of the material.

Effect of storage media, with all

provisional materials; there was no


between mean ΔRa of immersion media.

Conclusion:

Under the limitation of this study, several

conclusions as:-

Type of provisional restorative

materials, staining solutions and

immersion times are significant

factors that can affect color stability of

the five provisional restorative

materials tested.

Type of provisional restorative

materials was the only significant

factor for surface roughness, so

choosing type of material must be the

interest regarding to smoothness.

Under the conditions of this study,

CAD CAM provisional materials

were more color stable and less



change in surface roughness

compared to manually conventional

type in exception of protemp4 that

showed values very close or similar to

CAD CAM materials.

Coffee had the most effect in color

changes.

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